King George’s heart

The heart of a king

George II is the only British monarch known to have died while defecating. At about seven o’clock on the morning of October 25th, 1760, one of the page boys at Kensington Palace heard a loud noise from the King’s private apartment, as if a piece of furniture had fallen over.* When the valet went to investigate, he found His Majesty dead on the floor; he had been using his ‘necessary-stool’. The royal physicians were summoned, and since their patient was beyond any medical aid they were instructed to dissect and embalm the royal body. This is what they found:

Upon examining the parts, we found the two great arteries, (the aorta and pulmonary artery, as far as they are contained within the pericardium) and the right ventricle of the heart stretched beyond their natural state; and, in the trunk of the aorta, we found a transverse fissure on its inner side, about an inch and half long, through which some blood had recently passed, under its external coat, and formed an elevated echymosis.

An ecchymosis is an area of subcutaneous bleeding – essentially, a bruise.

The image at the top of this post is an engraving of George’s heart made during autopsy. The aorta is the arch-shaped blood vessel, and on the right-hand side you can just make out the bulge in its wall that killed him. This is known as an aortic dissection, a condition in which the inner wall of the artery becomes weak and tears, separating from the outer layers of the vessel. George’s is one of the earliest known examples.

*In his letters – but not his far more decorous official memoir of the king’s reign – the royal biographer Robert Walpole described this noise as being ‘louder than royal wind’.